Health of older people in places and work-related outcomes: are all health indicators equal?

Murray, E. T., Shelton, N., Norman, P., Head, J. (2021) European Journal of Public Health, 31, (Supplement_3), [ONS LS]

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Health has been posited as an explanation for why older people who live in more disadvantaged areas have worse work-related outcomes. The policy implication being that if a higher proportion of older persons in a place had better health, those labour markets would be better for everyone. No literature exists on this topic.Data was used from 428,646 members of the Office for National Statistics Longitudinal Study (LS) who were 16-74y at the 2011 census and had information on employment status, economic activity and occupational socioeconomic classification. Generalised Structural Equation Modelling was used to examine whether each of the three work-related outcomes were equally related to nine 2011 local authority district (LAD)-level older adult health indicators.In age-adjusted analysis, all nine LAD-level health indicators (modelled in terciles) were associated with all three work outcomes. However, strengths of association varied both across and within each outcome. For example, the strongest associations were for being ‘sick or disabled' versus ‘In employment'. If an LS member lived in the ‘unhealthiest' versus ‘healthiest' third of LADs, associations varied between a high of 2.74 higher odds (95% CI: 2.53,2.95) for long-term illness and a low of 2.10 higher odds (1.89,2.32) for disease-free life expectancy at age 50y. The weakest associations were for part-time versus full-time employment: ranging from life expectancy at birth at 1.29 (1.21,1.38) to healthy-life expectancy at age 50y: 1.18 (1.10,1.27). Adjustment for individual health reduced, but did not eliminate, associations. Sensitivity analysis showed robustness to area health indicators being assessed for sub-groups of older people (ages 50-64 & 65-74), genders and a reduced sample of older persons (50-74y) only.Health of older people in places is associated with work outcomes of people in those places; both the older people themselves and the wider community.At a place level, health and work outcomes are linked.Strengths of association between place-level health and work outcomes will depend on the health measure used.

Available online: European Journal of Public Health,
Output from project: 2000166


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